Impact of ezetimibe on plasma lipoprotein(a) concentrations as monotherapy or in combination with statins

a systematic review and meta-analysis of randomized controlled trials

Amirhossein Sahebkar, Luis E. Simental-Mendía, Matteo Pirro, Maciej Banach, Gerald F. Watts, Cesare Sirotri, Khalid Al Rasadi, Stephen L. Atkin

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Abstract

The aim of this meta-analysis of randomized placebo-controlled clinical trials was to assess the effect of ezetimibe on plasma lipoprotein(a) concentrations. Only randomized placebo-controlled trials investigating the impact of ezetimibe treatment on cholesterol lowering that include lipoprotein(a) measurement were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases (from inception to February 26th, 2018). A random-effects model and generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate the impact of potential confounders on lipoprotein concentrations. This meta-analysis of data from 10 randomized placebo-controlled clinical trials (15 treatment arms) involving a total of 5188 (3020 ezetimibe and 2168 control) subjects showed that ezetimibe therapy had no effect on altering plasma Lp(a) concentrations (WMD: −2.59%, 95% CI: −8.26, 3.08, p = 0.370; I2 = 88.71%, p(Q) < 0.001). In the subgroup analysis, no significant alteration in plasma Lp(a) levels was observed either in trials assessing the impact of monotherapy with ezetimibe versus placebo (WMD: −4.64%, 95% CI: −11.53, 2.25, p = 0.187; I2 = 65.38%, p(Q) = 0.005) or in trials evaluating the impact of adding ezetimibe to a statin versus statin therapy alone (WMD: −1.04%, 95% CI: −6.34, 4.26, p = 0.700; I2 = 58.51%, p(Q) = 0.025). The results of this meta-analysis suggest that ezetimibe treatment either alone or in combination with a statin does not affect plasma lipoprotein(a) levels.

Original languageEnglish
Article number17887
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - Dec 1 2018

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipoprotein(a)
Meta-Analysis
Randomized Controlled Trials
Placebos
Therapeutics
Ezetimibe
PubMed
Lipoproteins
Cholesterol
Databases

ASJC Scopus subject areas

  • General

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Impact of ezetimibe on plasma lipoprotein(a) concentrations as monotherapy or in combination with statins : a systematic review and meta-analysis of randomized controlled trials. / Sahebkar, Amirhossein; Simental-Mendía, Luis E.; Pirro, Matteo; Banach, Maciej; Watts, Gerald F.; Sirotri, Cesare; Al Rasadi, Khalid; Atkin, Stephen L.

In: Scientific Reports, Vol. 8, No. 1, 17887, 01.12.2018.

Research output: Contribution to journalArticle

Sahebkar, Amirhossein ; Simental-Mendía, Luis E. ; Pirro, Matteo ; Banach, Maciej ; Watts, Gerald F. ; Sirotri, Cesare ; Al Rasadi, Khalid ; Atkin, Stephen L. / Impact of ezetimibe on plasma lipoprotein(a) concentrations as monotherapy or in combination with statins : a systematic review and meta-analysis of randomized controlled trials. In: Scientific Reports. 2018 ; Vol. 8, No. 1.
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abstract = "The aim of this meta-analysis of randomized placebo-controlled clinical trials was to assess the effect of ezetimibe on plasma lipoprotein(a) concentrations. Only randomized placebo-controlled trials investigating the impact of ezetimibe treatment on cholesterol lowering that include lipoprotein(a) measurement were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases (from inception to February 26th, 2018). A random-effects model and generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate the impact of potential confounders on lipoprotein concentrations. This meta-analysis of data from 10 randomized placebo-controlled clinical trials (15 treatment arms) involving a total of 5188 (3020 ezetimibe and 2168 control) subjects showed that ezetimibe therapy had no effect on altering plasma Lp(a) concentrations (WMD: −2.59{\%}, 95{\%} CI: −8.26, 3.08, p = 0.370; I2 = 88.71{\%}, p(Q) < 0.001). In the subgroup analysis, no significant alteration in plasma Lp(a) levels was observed either in trials assessing the impact of monotherapy with ezetimibe versus placebo (WMD: −4.64{\%}, 95{\%} CI: −11.53, 2.25, p = 0.187; I2 = 65.38{\%}, p(Q) = 0.005) or in trials evaluating the impact of adding ezetimibe to a statin versus statin therapy alone (WMD: −1.04{\%}, 95{\%} CI: −6.34, 4.26, p = 0.700; I2 = 58.51{\%}, p(Q) = 0.025). The results of this meta-analysis suggest that ezetimibe treatment either alone or in combination with a statin does not affect plasma lipoprotein(a) levels.",
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